New Zealand study challenges ‘one size fits all’ approach to asthma treatment

Published Online: March 4, 2015

Diseases such as asthma and COPD vary greatly from person to person, and sometimes they overlap in the same individual. In order to give each person the most appropriate treatment, it is necessary to understand the different patterns, or “phenotypes,” of disease. It may be that different phenotypes should be treated differently.

In a study recently published in The Journal of Allergy and Clinical Immunology (JACI), Fingleton and colleagues present the results of the New Zealand Respiratory Health Survey. In this study, a random sample of 16,459 people was used to recruit 451 people with wheeze and breathlessness who were studied in detail. A technique called cluster analysis was then utilized to allow the researchers to determine the different patterns of airways disease and their responses to common treatments.

Five different phenotypes of airways disease were described. Phenotypes differed in their clinical characteristics including their response to bronchodilators and inhaled steroids, suggesting they may benefit from different approaches to treatment.  One of the most important findings in this study was that patients with the Asthma-COPD Overlap Syndrome (ACOS) may benefit from inhaled steroid therapy, in addition to bronchodilator treatments. The authors suggest that the current “one size fits all” approach to the management of asthma may be outdated, and that it may be preferable to work out the type of asthma a patient has, and tailor treatment accordingly.


The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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